title: Bridge to transplantation with the TandemHeart: bending the indications in a chronic aortic dissection patient with postcardiotomy shock.
abstract: Herein, we report a successful bridge to heart transplantation by use of the TandemHeart percutaneous ventricular assist device (pVAD) in a chronic aortic dissection patient who was experiencing postcardiotomy shock. The patient had undergone an aortocoronary bypass to treat an acute, extensive myocardial infarction that had resulted from severe stenosis of a Cabrol-like graft to the left main coronary artery. The TandemHeart was used successfully, despite classic contraindications for pVAD support. The outcome shows that, in critically ill cardiogenic shock patients, a permissive approach to pVAD use is valuable in screening candidates for long-term ventricular assist device support or for heart transplantation. This case also reveals the validity of direct bridging to transplantation from a pVAD in carefully selected patients.
authors.affiliation: Department of Cardiopulmonary Transplantation and Mechanical Circulatory Support, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77225-0345, USA.
authors.forename: Stephane
authors.initials: S
authors.lastname: Reverdin
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
authors.forename: Pranav
authors.initials: P
authors.lastname: Loyalka
authors.forename: Mark C
authors.initials: MC
authors.lastname: Bieniarz
authors.forename: Scott A
authors.initials: SA
authors.lastname: LeMaire
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Coselli
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D001026:Coronary Artery Bypass; D023903:Coronary Restenosis / Q000601:surgery*; D005500:Follow-Up Studies; D016027:Heart Transplantation; D019918:Heart Valve Prosthesis Implantation; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000601:surgery*; D011183:Postoperative Complications / Q000628:therapy*; D012086:Reoperation; D012770:Shock, Cardiogenic / Q000628:therapy*